Cancer Council ACT recommends that babies under 12 months not be purposely exposed to direct sunlight when UV levels reach 3 and above. A baby’s skin is thin, extremely sensitive and can damage easily. When babies and toddlers are participating in outdoor activities and events when UV levels are 3 and above, always use shade and a combination of sun protection measures to keep them well protected from the sun’s UVR.
A baby’s skin is thinner than an adult’s skin.1 It is extremely sensitive and will burn easily so sensible sun protection is required at all times when UV levels are 3 and above.2
When UV levels reach 3, babies should to be kept in the shade.3 Even while in the shade, UV radiation can reflect from surfaces such as water, sand and concrete, so it is important for your baby to wear a hat and appropriate clothing. As the sun moves, so does the shade, so keep a watch to make sure your child is still well protected from direct UV radiation.
When travelling, use a shade visor or hang a blanket over the side windows in the car. Side and back windows don’t offer as much protection as the front windscreen, which usually has a UV protection factor (UPF) of about 15 or less 4, blocking up to 93% of UV radiation. To provide adequate sun protection, products should have a UPF of 15 or higher.4
When buying a pram, pusher or stroller, check sure that the hood can be adjusted, so that it can be moved to block out the direct sun. Pram shade covers must provide maximum protection from UV radiation while being practical by allowing the baby to see out, and parent to see in.
For best protection, pram shade covers should:
- completely cover the pram – this gives full body protection
- be able to be fastened all around the pram and have no gaps where sunlight can enter
- be made of closely woven fabric which combines a mesh section – so the baby can see out and air can circulate – and a shade fabric section. The fabric section should block close to 100% of UV radiation (UPF 50+) and the mesh section should block at least 70% of UV radiation (UPF 3.3).
Covering as much of the baby’s skin as possible with cool, loose fitting clothes and wraps is an excellent form of sun protection. The higher the UPF number, the greater the protection provided by the fabric. If possible, buy clothing that has a UPF close to 50. If buying clothing that doesn’t have a UPF label, look for fabrics which:
- are closely woven: close weave prevents more UV radiation from getting through
- are made of natural fibres: these are usually the coolest type of fabric
- a are polyester or nylon: these have some natural UV radiation absorbing properties
- are cotton or cotton/polyester: these provide protection equal to about UPF 20 (which is about 95% protection from UV radiation).
Hats should protect the face, neck and ears. If the hat is secured with a long strap and toggle, it may be best to place the strap at the back of the child’s head so it doesn’t become a choking hazard. Many babies and toddlers do not like to wear hats and so persistence is needed to teach them that a hat is part of their outside routine.
When trying a new hat design, keep in mind its size and comfort and make sure it still allows the child to see and hear clearly.
Suitable sun protection hats include:
- a soft legionnaire style hat, with a flap at the back that meets at the front peak. For young babies, choose a design that will crumple easily when the baby puts their head down
- a bucket hat with a deep crown that sits easily on the child’s head and still allows them to see and hear clearly
- a broad-brimmed hat.
Baseball caps do NOT offer enough protection to the face, ears and neck and are therefore not recommended.
It is important to protect children’s eyes. Babies and toddlers may wear sunglasses that have soft elastic to keep them in place. It is important to choose a style that stays on securely so that the arms don’t become a safety hazard. Again your child may be reluctant to wear sunnies and may prefer them as a toy to play with! By acting as positive role models parents and carers can lead by example.
Toy or fashion labelled glasses do not meet the requirements for sunglasses under the Australian Standard and therfore should not be used to provide protection against solar UV. 5,6
If using sunglasses, look for ones that:
- are close fitting
- wrap around and cover as much of the eye area as possible
- meet the Australian Standard 1067 (Sunglasses: Category 2, 3 or 4)
- are preferably marked eye protection factor (EPF) 10. 7
Very young babies (less than 6 months of age) absorb more of any chemical applied to the skin than occurs for adults. For this reason, the Australasian College of Dermatologists does not recommend widespread and regular use of chemical sunscreens for babies less than six months of age.12 However, to date there have been no documented reports of harmful side effects that have occurred as a result of sunscreen absorption among babies. 12
The American Academy of Pediatrics has stated that sunscreens may be used on infants younger than 6 months on small areas of skin if adequate clothing and shade are not available.
Many brands of sunscreen have a babies or toddlers formula that offers the same degree of protection, but is much gentler on their skin. Sunscreens with titanium dioxide or zinc oxide work largely by reflecting UV radiation away from the skin, and are less likely to cause problems with sensitive skin as it is designed to sit on the skin surface.8
- it is always best to keep babies and toddlers out of the direct sun when UV levels are 3 and above, or wellprotected using other forms of sun protection, so that sunscreen use is kept minimal.
- test the sunscreen on a small area of the baby or toddler’s skin to make sure there won’t be any reaction.
- use at least an SPF 30 broad spectrum, water resistant sunscreen.
- apply the sunscreen 15-20 minutes before going outside and reapply every two hours or more is washed or wiped off.
- only use sunscreen with other forms of sun protection. It doesn’t offer enough protection if it’s used on its own.
- sunscreen should never be used to extend your child’s time outdoors.
Children often copy those around them and learn by imitation. Research shows that if adults adopt positive sun protection behaviours, the children in their care are more likely to do the same.9
For skin affected by nappy rash, recommendations include frequent nappy changing, applying barrier creams to the affected areas and exposing the inflamed area to the open air, as much as possible 10 but not the sun. Purposely exposing a baby to the sun puts them at risk of skin and eye damage.
Some UV radiation exposure is important for vitamin D production and maintainance. Vitamin D is needed for bone, joint, muscle and general health. When UV levels are low (under 3) small amounts of direct UV exposure is considered safe for babies and children and may assist them with their vitamin D requirements.11
The SunSmart App - daily sun protection times in your pocket.
Parents can clearly view what time of the day sun protection is recommended in Canberra by simply downloading Cancer Council's free SunSmart app to their phone.
Neonatal jaundice generally only causes concerns in about 10% of babies.10 Jaundice should be treated under medical supervision in a controlled environment. Purposely exposing a baby to direct sunlight (UVR) is not recommended to treat neonatal jaundice.
What about babies with naturally very dark skin?
While children with white skin are obviously more prone to skin damage and sunburn and therefore an increased risk of skin cancer later in life, darker skin can still be damaged by UV. Every child in Australia, regardless of skin colour, should still protect their skin and eyes from over-exposure to UV. Children with naturally very dark (ie African) should still apply sunscreen if spending longer periods outdoors, especially in Summer when UV levels peaks. They should always aim to protect their face and eyes from too much sun by wearing a brimmed hat and sunglasses whenever UV levels are 3 and above, and using shade when it is available.
Families with children who have naturally very dark skin who rarely/never burn are encouraged to discuss their sun protection and vitamin D requirements with their GP.
Further information and resources
This information is based on current available evidence at the time of review. For further information or advice contact Cancer Council 13 11 20 or view Cancer Council Australia's Position Statement: Sun Protection and Infants (0-12 months).
This information can be photocopied for distribution.
1. Seidenari S, Giusti G, Bertoni L, Magnoni C, Pellacani G. Thickness and echogenicity of the skin in children as assessed by 20-MHz ultrasound. Dermatology 2000;201(3):218-22 [Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/11096192.
2. Cancer Council Australia Position Statement: Sun Protection and Infants (0-12 months). Endorsed by Australasian College of Dermatologists. June 2013.
3. World Health Organization. Ultraviolet Radiation and the Intersun Program. Geneva: World Health Organization 2001
4. Australian Radiation Protection & Nuclear Safety Agency (ARPANSA). Resource Guide for UV Products. Yallambie: ARPANSA 2003, Ref. 10, Ref. 13.
5. Choice. Eye safety. Sunglasses. Choice Magazine 1999; 8–11 October.
6. Australian Standard AS 1067 (2003) (Sunglasses and Fashion Spectacles).
7. Cains S. Royal Australian College of Opthalmologists policy statement on sunglasses. Med J Aust 1992;157: 343–4.
8. Sullivan JR. A-Z of Skin: Baby and Toddler Protection. Australasian College of Dermatologists, 2001. Retrieved from http://www.dermcoll.asn.au/public/a-z_of_skinbaby_toddler_protection.asp on 31 October 2006
9. Dobbinson S, Fairthorne A, Bowles K-A, Sambell N, Spittal M, Wakefield M. Sun protection and sunburn incidence of Australian children: summer 2003–04. Melbourne: Centre for Behavioural Research in Cancer, Cancer Council Victoria; 2005 July.
10. Harrison S, Buettner P, MacLennan R. Why do mothers still sun their infants? J Paediatr. Child Health.1999;35: 296.
11. Cancer Council Australia Position Statement: Sun protection and Infants (0-12 months). Endorsed by the Australasian College of Dermatologists. June 2013
12. Guitera, PA. A-Z of skin: Sun protection and sunscreens. [homepage on the internet] Rhodes, Australia: Australasian College of Dermatologists; 2016 [cited 2016 Feb 19]. Available from: https://www.dermcoll.edu.au/atoz/sun-protection-sunscreens/